Current state of type 1 diabetes treatment in the U.S. Updated data from the t1d exchange clinic registry

Kellee M. Miller, Nicole C. Foster, Roy W. Beck, Richard M. Bergensta, Stephanie N. DuBose, Linda A. DiMeglio, David M. Maahs, William V. Tamborlane

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Abstract

To examine the overall state of metabolic control and current use of advanced diabetes technologies in the U.S., we report recent data collected on individuals with type 1 diabetes participating in the T1D Exchange clinic registry. Data from 16,061 participants updated between 1 September 2013 and 1 December 2014 were compared with registry enrollment data collected from 1 September 2010 to 1 August 2012. Mean hemoglobin A1c (HbA1c) was assessed by year of age from <4 to >75 years. The overall average HbA1c was 8.2% (66 mmol/mol) at enrollment and 8.4% (68 mmol/mol) at the most recent update. During childhood, mean HbA1c decreased from 8.3% (67 mmol/mol) in 2-4-year-olds to 8.1% (65 mmol/mol) at 7 years of age, followed by an increase to 9.2% (77 mmol/mol) in 19-year-olds. Subsequently, mean HbA1c values decline gradually until 30 years of age, plateauing at 7.5-7.8%(58-62mmol/mol) beyond age 30 until amodest drop inHbA1c below 7.5% (58mmol/mol) in those 65 years of age. Severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) remain all too common complications of treatment, especially in older (SH) and younger patients (DKA). Insulin pump use increased slightly from enrollment (58-62%), and use of continuous glucose monitoring (CGM) did not change (7%). Although the T1D Exchange registry findings are not population based and could be biased, it is clear that there remains considerable room for improving outcomes of treatment of type 1 diabetes across all age-groups. Barriers to more effective use of current treatments need to be addressed and new therapies are needed to achieve optimal metabolic control in people with type 1 diabetes.

Original languageEnglish (US)
Pages (from-to)971-978
Number of pages8
JournalDiabetes care
Volume38
Issue number6
DOIs
StatePublished - Jun 2015

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Type 1 Diabetes Mellitus
Registries
Hemoglobins
Diabetic Ketoacidosis
Hypoglycemia
Therapeutics
Age Groups
Insulin
Technology
Glucose
Population

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Miller, K. M., Foster, N. C., Beck, R. W., Bergensta, R. M., DuBose, S. N., DiMeglio, L. A., ... Tamborlane, W. V. (2015). Current state of type 1 diabetes treatment in the U.S. Updated data from the t1d exchange clinic registry. Diabetes care, 38(6), 971-978. https://doi.org/10.2337/dc15-0078

Current state of type 1 diabetes treatment in the U.S. Updated data from the t1d exchange clinic registry. / Miller, Kellee M.; Foster, Nicole C.; Beck, Roy W.; Bergensta, Richard M.; DuBose, Stephanie N.; DiMeglio, Linda A.; Maahs, David M.; Tamborlane, William V.

In: Diabetes care, Vol. 38, No. 6, 06.2015, p. 971-978.

Research output: Contribution to journalArticle

Miller, KM, Foster, NC, Beck, RW, Bergensta, RM, DuBose, SN, DiMeglio, LA, Maahs, DM & Tamborlane, WV 2015, 'Current state of type 1 diabetes treatment in the U.S. Updated data from the t1d exchange clinic registry', Diabetes care, vol. 38, no. 6, pp. 971-978. https://doi.org/10.2337/dc15-0078
Miller, Kellee M. ; Foster, Nicole C. ; Beck, Roy W. ; Bergensta, Richard M. ; DuBose, Stephanie N. ; DiMeglio, Linda A. ; Maahs, David M. ; Tamborlane, William V. / Current state of type 1 diabetes treatment in the U.S. Updated data from the t1d exchange clinic registry. In: Diabetes care. 2015 ; Vol. 38, No. 6. pp. 971-978.
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